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B ILDING. INSPECTOR BECORD
<br />SITE.WORK DATE ID/SIG.. COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFEB Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsu lation/E nerq y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />N4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL (/hs//q dtlhtD t/tf2-
<br />Certiticate ot Occupancy { t /
<br />NotBS, Remarks, Etc
<br />d
<br />/t I
<br />OWNEA BUILDA,T DT,LCTTATION
<br />I h.Ehy .frrn udcr F lly of Frjltry rhd I e .rcq fhfl rrE (i,nrdun LiccnE br ror rlE folk li.8 Mqn l S- rol l.J
<br />Bu\im.t un PR rcs*,n CsL) Any Cny or Counr, qhi.h ,.q!t.r r Frmlt t, n,nnrud, rlrd, ii{mrt. dcmlirh ot EIf,n dy
<br />{Blm, Fir r' irs csumc, .lro rcariB rlt +riter rd *n Fmr b nk. .i8md ir.mnl lhr li o, tlE k lftn*d lorsln
<br />tu rh. rovkn)N orlrE conlmclols Lic.ns.d liw lch! d e. Commncin! *irh sc.rio.7(xD of Divisi{,n .1 of llt Butin$!,nd
<br />hofc$irn\ C.d.) or lll.l rE or rl! Lr.r.qr rlEEfroi,rl rlr haris fo h. .lb8.d .rc.ryrirn Any rioLrion 6r Sd.n ,01I 5 by.ny
<br />ipptio rd, r Fmir rubFk rh. +Ilaa.' t, t civil p.Ent or mt 'E lhln nv. htndrcd drll6 (tlm).
<br />-1,
<br />( owE of th FsFny. G By.nplorEr *nh w.sd.r rlln $b oqrMrion, d!! &' E wdt rn 0E {^tlft i. mr
<br />itrl.nd.d or olY.Ed for sk (Sd.7Or4, Busie.i snd Pror.*ioN Crxl.: 'nE Ctnr&roi. Uens l,* d.Ei Nr lPply.o rn o*xr of
<br />ilE FDFny eb hriLlr n iqm6 oE@tr rn wio d(B ui HrI hid€lf or h.rclf o. rhrcuah hii r h.r owo.npt }!.r.
<br />nrevird rh.r rufi inIr,r(cfi e d ir.rilcd trotud for qh tl lD*N, rlt txiuiB or htrtrf,d ir nld *rnin m FE
<br />olor{,krior rlE Owmr Buitkr wi! h[E llr hFk of !rcvilB rhd lr r $c dA d hil, or i,rrfth riE pmFny lor llE Fqnr.I
<br />-1,
<br />!r owmr ol rhc fniF.ry, .m exclulivcl, coorErirg sirh lic.nEd .unrr.r'^ (o $nnrud lh. poi.rr (scc 7l)44. au$rcs
<br />rd Pr'6sin (i,& T& Cont(ror'r Lenr trs &.r mi .mly to .n owrr ol I'.orEn y $h, l{ ildr or innov.r rh.t@n-
<br />d.d Eho crdftk nr sEn I,Di{r wiib ' ( onrncro(n lirn<i poFu.r k, rlE Cndrrroi\ l,auE ll*r
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<br />oqcnl]l u,nc. scrbn
<br />ul,!-lt&tUra
<br />I herchy !0nm under ltullyof
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<br />hovc oln will mrllin a (tnifEar. ol Conrn' nr s.lr lniuE fn wtrkdt ..nu.nsurion, 3s pmvidcd ror h, s.crk,n .17(n or rhc
<br />Ub.r (t,.L. td rrE FfixfrE! of lrE q't nn *hth ',t ,crnir ir isrEd
<br />-l
<br />huv! rnd *ill roinroin work.h co'hlxnlariir iisorsft., trr rcquncn hy Scdrn'tr .l?(xr ol ln I f,&tr Qxl.. r(r rh. !(rfo,nutuc of
<br />rtE r.rk fn r hih ihx Fmir il i$il My *0116 ()n{Enu.. in$PEc (!tricr u,Iiniy numtf,r 6:
<br />PolicyNumhcr-
<br />I c.diry rhlr
<br />'n
<br />rh Frlormr or trr uort nn *h.h lht Frmn n i{Ed. l.hrll br .rY{'hy rny F{fl h.ry nBd
<br />$ s to hcor NbF o r,E *6rl6i onFh*r io. ld*s or Crhkmn. rnd !8N rnai il I \hruu hccorE rubl.d r. rh.
<br />hrl(r' oryxtrdir FDrni,n. ol sarrn lrm ol rh. lrbr C.d.. I thlL nxln*nh on pl, *irh rlr,. tmviii'ns
<br />WARNINC: l..ituE tu suE *rrls olIrrnsr,bn @!osc ir unlrwru!. .d {EIl iuhis u .trpbF r. (rmMl Fmii\ !d
<br />.ivil fir.\ un l. onc [un,lrrl rhou\rnl dolltr^lx)(xxD. i" r'lJirii,n r, rh..oi "l .dmnrtr\rrntrr.,hInrB.\ r\ P'o!iltd l,r rhc
<br />S(rhtr .r)76 ol ttF titrtr Cqi.. inrcr( r.d
<br />u(r,$lrr.t r&i!l!B
<br />r&!L\&urQr
<br />I h.ftby firm trn].r Fn ry urFrjury I r.vtir ol Chrfl( 9 ( u rftlri,rf * irh S(ti,n 7(lI) ol Dir^iir l
<br />ot rlr Bnsi6r ri Prnfdrb.r CeL..rd ny ti.m n n fnll fora.ri clldr
<br />t-i..nr.Chrs-
<br />(a&uf,ucllaNu,lDMillililcr
<br />I h.Eby alltfludts rrDlry ol pcrjDry rhd rh.r ir a.r,antudi)n k l'hSc8ttuytu rlr pltl|rroEr olrh. *ort tu rh.hrhirlumr s
<br />l.nLrr Adrr..r
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<br />AfILIISII.IIEII.A8A:III]N
<br />I hctl'y ltrm ullcr Fn.lr, o, Frtry oE or rtE rolk *rn8 d..L,.'it.r
<br />I)cfrrirnn PcrmnsAsh.slos Noliacllion Fcdcrrl RcI!lalions lTnt.()- Pfi 6)
<br />Rquinn l.krof |{rfrrrn
<br />_l ..nify rhll r,E,.<t xl rc8ul{i,nr rc8ldin8 rshstx ftmrhl G B{ +rl.il'lc ro ihi{ pn'r.r
<br />turb. en (!r. rh.r thc {vc i.fornurii,n is..mi l!86k,omply*nh.llCnya.dCooiry
<br />hrildins mn(ucrior rn lmhy .lrhniz r.F.rdcriw! or rhir Cny !n Counry r{' or. uFn tlt
<br />l,ak\ ela 6kfanio. t-i rs.re;".Lb.lq
<br />Set Backs
<br />x
<br />irsucd (S.. llp?, Civ c.r.
<br />l(nd(r'! N,m
<br />I
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